The Oregon Health Plan (OHP), Oregon's innovative Medicaid program, is at risk of collapse. Cost containment strategies are being implemented that segregate the OHP population into two groups. What will happen to the group of people who will incur higher premiums and significant co-pays in terms of access to care, continuity, health status, and health outcomes? These policy changes challenge researchers to continually test the hypotheses that: (1) Having health insurance and/or a usual source of care is linked to better access and improved health outcomes; and (2) Cost sharing, benefit reduction and other measures to control spending within insurance programs may compromise access and continuity of care. This project aims to test the first hypothesis by examining whether health insurance and a usual source of care are associated with superior service delivery and health outcomes. The second hypothesis will be tested through an analysis of how OHP benefit reductions, premiums, and co-pays affect the ability of Medicaid-eligible individuals to maintain health insurance and to preserve a relationship with a usual source of care. This research will provide policy-relevant information to insurers of vulnerable populations. [unreadable] [unreadable]